NPIMap

Individual provider Active NPI

Jad Marwan Bou Ayache, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1164858619
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
276731 Issued in NY
Practice address
1468 Madison Ave
New York, NY 10029-6508
Phone
(773) 780-4432
NPI assigned
Sep 16, 2013
Last updated
Dec 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 276731 NY Primary

Addresses

Primary practice location

1468 Madison Ave
New York, NY 10029-6508

Mailing address

1468 1 Gustave L Levy PL
Apt 5G
New York, NY 10029
Phone (773) 780-4432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161109001443 NY Practitioner - Diagnostic Radiology 7113206442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mskcc Radiology GroupGroup PAC ID 3971494683, 192 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Nuclear Medicine Group CurrentSince Oct 15, 2017 Accepting new patients
Fpa Hospital Based Diagnostic Radiology CurrentSince Nov 1, 2016 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Mskcc Radiology Group Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients
Fpa Hospital Based CurrentSince Nov 1, 2016 Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1164858619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 1 GUSTAVE L LEVY PL",
            "address_2": "APT 5G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "773-780-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "773-780-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOU AYACHE",
        "first_name": "JAD",
        "middle_name": "MARWAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-16",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "276731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.